Targeted delivery of antimicrobial agents

ABSTRACT

A cationic antimicrobial peptide (CAMP) conjugate is disclosed. The CAMP conjugate may be made by identifying a suitable carrier peptide; identifying a suitable antimicrobial agent; creating a conjugate by conjugating the peptide with the antimicrobial agent; and evaluating and refining the conjugate. The peptide may be short peptide based on the sequence of a CAMP, such as human β-defensin-3. The peptide can be directly connected to the antimicrobial agent or through a linker segment. The antimicrobial agent may be connected to the peptide or the linker segment through stable or cleavable bonding. The peptide may carry and facilitate the delivery of the conjugated antimicrobial agent to a microbe.

CROSS REFERENCE TO RELATED APPLICATIONS

The present application is a continuation of U.S. application Ser. No.12/502,420, filed Jul. 14, 2009, which claims the benefit of ProvisionalPatent Application Ser. No. 61/081,557, filed on Jul. 17, 2008, both ofwhich are hereby incorporated by reference.

BACKGROUND OF THE INVENTION

Before the discovery of antibiotics, community-acquired infections werea major threat to the health and welfare of people in the United States,and they continue to be a major problem in developing countries.However, soon after the discovery of penicillin and wide spread accessto antibiotics in the 1940's, bacteria began to develop varied degreesof resistance to these drugs. While new drugs have been introduced sincethe discovery of penicillin, the majority of them are the result ofvaried combinations of substituents on one of about 9 molecularscaffolds. There should be no surprise that the number of microbesdeveloping resistance is growing rapidly, and that their resistancemechanisms are becoming more sophisticated. For example, antibioticresistance was initially a problem associated with nosocomialinfections. But now, there has been an increase in occurrences incommunity acquired cases. Antibiotic resistance appears to now threatenthe utility of “last resort” drugs, such as vancomycin, the drug ofchoice for treating methicilin- and multidrug-resistant Staphylococcusaureus infections. The problem of antibiotic resistance is farthercomplicated by the threat of bioterrorism, and the potential use ofpathogens that have been intentionally altered in order to enhance theirresistance to antibiotics and to enhance their virulence or lethality.

Today, gastrointestinal pathogens continue to present a threat to thehealth of Americans and people worldwide, particularly children indeveloping nations. While many of these illnesses can be treated,several of them (such as shigellosis and cholera) can have fatalconsequences if untreated. There is an urgent need to develop newtherapeutics to better address this threat. It has been estimated thatas many as about 325,000 Americans are hospitalized and up to about5,000 die per year due to food-borne pathogens and the resultinggastrointestinal (GI) infections.

The Shigella family of bacteria is a particularly virulent group ofgastrointestinal pathogens that are spread by contaminated food orwater. Infection can occur with as few as 10 ingested cells. Accordingto the Centers for Disease Control, as many at 18,000 cases ofshigellosis are reported in the United States each year, and it isestimated that the actual number of cases in the United States is closerto 300,000 per year. Shigellosis is a greater problem in developingcountries, accounting for about 99% of the estimated 165 million casesworldwide each year. Children in developing countries are particularlysusceptible to shigellosis, with children under five accounting fornearly 60% of the ˜1.1 million deaths each year.

In 1994, there was an outbreak of Salmonella enteriditis in the UnitedStates that affected approximately 224,000 people. This outbreak wastraced to a tanker shipment of contaminated liquid ice cream.

An outbreak of Salmonella typhimurium in Illinois in 1985 affected over170,000 people as a result of contaminated milk. What made this outbreakparticularly disturbing was the fact that the strain of S. typhimuriuminvolved demonstrated resistance to nine different antibiotics.

There are other known pathogens of greatest concern. For instance, theassociated illness for pathogen Salmonella typhi is acute fever,diarrhea and potential intestinal rupture. The associated illness forpathogen Shigella dysenteriae is dysentery, with a fatality rate of upto about 20%. The associated illness pathogen Escherichia coli (E. coli)(0157:H7) is acute hemorrhagic diarrhea and possible long-term problems.The associated illness pathogen for Vibrio cholerae is severe diarrhea,with up to about 50% fatality rate.

A variety of strategies have been reported for the targeted delivery ofantimicrobial agents to bacteria. In creating antibiotics for suchpathogens, compounds were selected based on their ability topreferentially affect systems or features that are unique to microbe(s).They have also been selected based on being sufficiently different fromanalogous systems or features in host cells. However, many compoundsthat show very potent antimicrobial activity tend not to be suitable foruse as therapeutics due to undesirable side effects or poor selectivetoxicity. Targeted delivery is expected to allow the use of alternativeantimicrobial agents, such as nitric oxide (NO), that are less specificin the types of cells they affect and may even have broader impact. Yet,if delivered nonspecifically, undesirable side-effects may result.Furthermore, while a diverse range of strategies for targeted deliveryof therapeutics have been explored for the selective delivery ofchemotherapeutics to cancerous cells, they have only recently beeninvestigated for the treatment of infectious disease.

For example, constructs based on chlorine₆ conjugated to polylysines ofvaried lengths and varied degrees of substitution have been investigatedagainst representative gram-negative and gram-positive bacteria for theintracellular delivery of the photosensitizer (chlorine₆). In thesestudies, cells were treated with the conjugate and then exposed to 660nm light, which triggers the generation of singlet oxygen and freeradicals leading to cell death. While useful in localized applications,polylysine conjugates are generally not well suited for systemicadministration. They tend to provide limited specificity in theirdelivery of attached drug moieties by entering host cells, as well asinvading microbes.

Similar polylysine peptides have been used for the transduction ofproteins across the membranes of mammalian cells.

Even liposomes have been explored for the intracellular delivery ofaminoglycoside antibiotics. It has been reported that theliposome-encapsulated aminoglycosides demonstrated significantlyimproved potency over the corresponding free drugs, when evaluatedagainst Pseudomonas aeruginosa for the treatment of pulmonaryinfections.

Additionally, filamentous phage has been used for the targeted deliveryof chloramphenicol as a model antibiotic. These phage-based constructsincorporate a filamentous phage that had been selected from a phagelibrary for specific binding to S. aureus. As anticipated,chloramphenicol-phage conjugates with 2,000-4,000 drug molecules/phageretarded S. aureus growth, while comparable concentrations of freechloramphenicol had no significant impact on growth. As with antibodies,the specificity of phage-derived peptides makes them very specific forthe target pathogen. However, at the same time, their specificity mayalso prevent their utility with organisms other than the one for whichthey were designed.

Thus, there is an urgent need to develop new antibiotics and approachesfor treating infections.

BRIEF DESCRIPTION OF THE DRAWINGS

FIG. 1 shows an example of a levofloxacin-Peptide-4 conjugate.

FIG. 2 shows an example of a flow diagram of creating a CAMP conjugatewith levofloxacin.

FIG. 3 shows a specific example of a flow diagram of creating alevofloxacin-hBD-3 conjugate.

FIG. 4 shows an illustration of the three-dimensional structure andamino acid sequence of hBD-3 (SEQ ID NO:1), and the sequence of hBD-3based Peptide-1 (SEQ ID NO:2).

FIG. 5 shows another version of the amino acid sequence of hBD-3 (SEQ IDNO:1).

FIG. 6 shows an example of synthesizing diazeniumdiolates.

FIG. 7 shows an example of drug-peptide conjugates being attracted tobacterial membranes.

FIG. 8 shows a general strategy of conjugating antibiotics to a peptidecarrier via carboxylic acid groups present in the drug molecule.

FIG. 9 shows an exemplified graph of antimicrobial activity (EC₅₀) forpeptides and their acetylated derivatives, as well as an exemplifiedgraph of the relationship between antimicrobial activity and nominalpeptide charge at pH7.

FIG. 10 shows an exemplified graph of hemolytic activity of Peptide-1,Peptide-2, Peptide-3, and Peptide-4 and their acetylated derivatives.

FIG. 11 shows chloramphenicol and the chloramphenicol-linker adduct.

FIG. 12 illustrates direct attachment of levofloxacin to a peptide.

FIG. 13 shows levofloxacin and the levofloxacin-linker adduct.

FIG. 14 shows an example of MALDI-TOF spectra of levofloxacinconjugates.

FIG. 15 shows an example of LC calibration curve for levofloxacin insolution and analysis of conjugates for the presence of freelevofloxacin.

FIG. 16 shows a survival curve illustrating the percent of survival rateof E. coli against a levofloxacin-peptide conjugate and a mortalitycurve illustrating the death percentage of E. coli against thelevofloxacin conjugate. These curves were generated using the same dataset and represent two approaches to presenting the data.

FIG. 17 shows methoxymethyl-protected monodiazeniumdiolate ofpiperazine.

FIG. 18 shows the succinimido ester (Dda-OSu) is prepared by treatingDda with dicyclohexylcarbodiimide (DCC) and N-hydroxysuccinimide (HOSu).

FIG. 19 shows an example of the antimicrobial activity for Pep-1, Pep-2,Pep-3, Pep-4 and their acetylated derivatives.

FIG. 20 shows antimicrobial potency (EC₅₀) of the four decapeptides andtheir acetylated derivatives as a function of nominal charge at pH 7.

FIG. 21 shows hemolytic activity of (A) Pep-1, Pep-2, Pep-3, and Pep-4and (B) acetylated Pep-1, Pep-2, Pep-3, and Pep-4.

DETAILED DESCRIPTION OF THE INVENTION

The present invention relates to developing novel strategies forleveraging the therapeutic potential of cationic antimicrobial peptides(CAMPs), such as targeted delivery of antimicrobials.

Historically, antibiotics have been chosen based on their selectivetoxicity. However, many compounds with potent antimicrobial activity arenot suitable for use as therapeutics due to undesirable side effects orpoor selective toxicity. As a way around this problem, targeted deliverymay allow the use of normally unsuitable antimicrobial agents byreducing their adverse side effects. Although a diverse range ofstrategies for the targeted delivery of therapeutics has been exploredfor the selective delivery of chemotherapeutics to cancerous cells, theyhave only recently been investigated for the treatment of infectiousdiseases.

Many of the properties that make antimicrobial peptides an effectivedefensive mechanism in higher organisms can also make them ideallysuited as a platform for targeting microbes for delivery of potentantimicrobial compounds (such as NO, etc.). This platform may provide aninvaluable therapeutic tool for treating infections (such as those inthe gastrointestinal tract, respiratory system, circulatory system,lymphatic system, urinary system, muscular system, skeletal system,nervous system, reproductive system, etc.), and could allow the use ofnovel antimicrobial agents, which would otherwise be unsuitable astherapeutics.

Some interior surfaces of the body, such as the respiratory and thegastrointestinal (GI) tracts, are topographically equivalent to exteriorsurfaces of the body. Because these surfaces are constantly exposed topotentially pathogenic microbes and are conducive to bacterial growth,novel therapeutic agents and strategies are needed for treatinginfections of the respiratory and GI tracts, particularly those causedby antibiotic resistant pathogenic microbes. Select agents (such asFrancisella tularensis, Bacillus anthracis, and Yersinia pestis, whichare known to cause life-threatening pneumonic infections and may berendered antibiotic resistant) are of particular concern as potentialbiological weapons.

Similarly, foodborne and waterborne pathogens (such as Shigelladysenteriae, Vibrio cholera, and Salmonella typhi) are consideredpotential biological threats that could be employed by terrorists tocontaminate food and/or water supplies. While infections by many ofthese microbes are usually responsive to treatment with antibiotics,illness resulting from intentional exposure will likely involveorganisms that have been engineered to be resistant to conventionalantibiotics.

As a solution, CAMPs may be used. CAMPs provide an ideal model for thedesign of delivery vehicles that target many bacteria, bothGram-positive and Gram-negative. While there is debate regarding thespecific antimicrobial mechanisms employed by CAMPs and the extent towhich internal targets are involved, these peptides have been shown toattack and disrupt bacterial membranes. In targeting bacteria, CAMPscapitalize on a fundamental physical property of bacterial membranes(negative charge density). The present invention differs from knownefforts in developing CAMP-based therapeutics in that the presentinvention aims to capitalize on their selective targeting, but does notrely on the peptide alone to kill the microbe. Instead, this strategyuses the peptide as a vehicle for the targeted delivery of more potentantimicrobial agents. Should the promise of targeted delivery of potentantimicrobial agents be realized, peptide-based drug conjugates(sometimes referred to as peptide-drug conjugates orpeptide-antimicrobial agent conjugates) could provide powerfultherapeutics for the treatment of a broad spectrum of infections,especially respiratory infections.

As an embodiment, smaller peptides are preferable to larger and morecomplex CAMPs because they are more easily synthesized andcharacterized. They also allow greater control in preparing drug-peptideconjugates. For example, a series of short peptides (12 to 10 residues)based on the C-terminal region of human beta-defensin-3 may be preparedsince peptides based on this region had previously been reported to bepotent against E. coli. Four decapeptides and their acetylatedderivatives may be generated to evaluate how attachment of drug moietiesthrough acylation to primary amino groups in the peptides and theassociated loss in positive charge may affect their ability to targetbacteria (such as E. coli) while leaving host cells (such aserythrocytes) unharmed. The performance of the free and acetylatedpeptides suggests a complex relationship between peptide charge andpotency. Additional carrier peptides may be designed using differentpeptides, such as defensins (alpha and beta), cathelicidins, protegrins,indolicidins, histatins, tachyplesins, etc.

Model drug-peptide conjugates may be produced using, for example,levofloxacin and the decapeptide that showed the greatest potency whenacylated. Using matrix-assisted laser desorption/ionization time offlight (MALDI-TOF) mass spectrometry, one can analyze the loading oflevofloxacin on the peptide. One can then evaluate the performance ofthe drug-peptide conjugates against E. coli. These studies can beexpanded to include additional microbes (such as F. tularensis and S.aureus) and eukaryotic cells (such as epithelial cells and hepatocytes).Alternative linkage chemistries, peptide carriers and antibiotics mayalso be determined using these processes.

Unlike prior approaches that have been suggested for targeted deliveryof antibiotics, this delivery strategy is not a pathogen-specificapproach. Rather, it a broad antibacterial approach. For example, thepresent invention enables inhalation treatment of respiratoryinfections, oral treatment of gastrointestinal infections, etc. Themodular nature of the proposed carrier peptides and the resultingdrug-peptide conjugates makes creates a highly flexible and broadlyapplicable platform for treating such infections, including those inwhich microbes are resistant to conventional therapies. The ability totarget delivery to the microbes dramatically expands the repertoire ofpotential antibiotic moieties to include compounds that are otherwisetoo cytotoxic for use.

Referring to the figures, FIG. 1 shows an example of a CAMP conjugate(i.e., levofloxacin-Peptide-4 as shown), and FIG. 2 shows an exemplifiedflow diagram of producing a CAMP conjugate. Steps include: identifying asuitable carrier peptide S205; identifying a suitable antimicrobialagent S210; creating a conjugate by conjugating the peptide with theantimicrobial agent S215; and evaluating and refining the conjugateS220. As one embodiment, the peptide is a short-peptide based on thesequence or portion of a sequence of a CAMP. As another embodiment, thepeptide is directly connected to the antimicrobial agent or through theuse of a linker segment. The antimicrobial agent may be connected to thepeptide or the linker segment through either a stable or a cleavablebond. As another embodiment, the peptide carries and facilitates thedelivery of the conjugated antimicrobial agent to a microbe.

In essence, The CAMP conjugate comprises at least one peptide conjugatedwith an antimicrobial agent. The peptide is a short peptide based on thesequence or portion of a sequence of a CAMP. Furthermore, the peptide isdirectly connected to the antimicrobial agent or through a linkersegment. The antimicrobial agent being connected to the peptide or thelinker segment through stable or cleavable bonding. Moreover, thepeptide carries and facilitates the delivery of the conjugatedantimicrobial agent to a microbe.

In yet another embodiment, the linker segment affixes the antimicrobialagent to the peptide through acylation of the amino group of theN-terminus of the peptide. As a further embodiment, the peptide carriesand facilitates the delivery of the conjugated antimicrobial agent to amicrobe.

In yet a further embodiment, the antimicrobial agent is directlyattached to the peptide.

The peptide may be a short peptide. “Short peptide” refers to anypeptide that has about 4 residues to about 100 residues. As anembodiment, the peptide may have about 4 residues to about 10 residues.In addition, it is possible that the peptide may have less than 4residues, such as non-natural amino acids. Examples of non-natural aminoacids include, but are not limited to, oranthene (which is lysine minusone amino acid), N—N-dimethyl substituted lysine residue, fluoroaniline,etc.

In yet a further embodiment, the CAMP is a beta-defensin (alsohereinafter denoted as β-defensin). β-defensin based peptides mayinclude any peptide having at least a portion of an amino acid sequenceof a human β-defensin, such as human β-defensin-3. For instance, suchportion includes peptides based on the last 10 residues of the aminoacid sequence comprising RGRKCCRRKK (SEQ ID NO:4). While this exampleuses the tail end of the amino acid sequence, the sequence can be anyportion of an animal peptide. For instance, the sequence or portion ofthe sequence may be in the front, middle, or end of the peptidesequence. Furthermore, any number of residues may be considered from thesequence or portion of the sequence.

Any residue of any amino acid sequence may be modified to createparticular variants. As an embodiment, using the above last 10 residuesas an example, the partial amino acid sequence may be RGRKSSRRKK (SEQ IDNO:2) (where the fifth and sixth amino acid are replaced with serine).As another embodiment, the partial amino acid sequence may be RGRRSSRRKK(SEQ ID NO:3) (where the fourth amino acid of the above last 10 residuesare replaced with arginine, and where the fifth and sixth amino acid ofthe above last 10 residues are replaced with serine). As anotherembodiment, the partial amino acid sequence may be RGRKSSRRKK (SEQ IDNO:2) and an amide group located on the C-terminus (SEQ ID NO:5). Asanother embodiment, the partial amino acid sequence may be RGRRSSRRKK(SEQ ID NO:3) and an amide group located on the C-terminus (SEQ IDNO:6).

Using small synthetic peptides allows the incorporation of non-naturalamino acids,

Such incorporation may introduce new functional groups (such asaldehydes) into the peptide that allow linkage chemistries that are notaccessible in natural peptides and proteins.

In the broader sense, conjugation chemistry is tailored to thefunctional groups present on the drug (e.g., antimicrobial agent) andthe linkage chemistry that they allow. If necessary, a bridge (e.g.,succinic or glutaric acid) can be incorporated that provides groupscompatible with linking the drug to the peptide. In such a case, a group(e.g., a carboxylic acid) on the bridge is used to form a linkage withthe drug, and another functional group (e.g., a second carboxylic acid)on the bridge is used to form a linkage with reactive functional groups(e.g., primary amines) present in the peptide.

The antimicrobial agent can be a host of various compounds. Nonlimitingexamples include levofloxacin, chloramphenicol, diazeniumdiolates, etc.

The connection between the peptide and antimicrobial agent can be madeusing the side chain groups present in the peptides and/or the amine orcarboxyl groups at the ends of the peptides. The antimicrobial agent canbe attached directly to these groups, or through a bridging group (e.g.,succinic or glutaric acid). In either approach, the nature of the bondconnecting the drug molecule to the peptide or linking group can eitherbe stable to environmental and biological processes or subject tocleavage by the same processes. Examples of stable bonds include, butare not limited to, secondary amines formed via reductive amination,triazine-based linking groups, etc. Examples of cleavable bonds, includebut are not limited to, ester bonds, amide bonds, etc. Depending on thenature of the connected groups, cleavable bonding can be susceptible tocleavage by environmental and/or biological processes. For example, anester bond connecting a drag moiety to the side chain of a serineresidue in the peptide may be recognized by enzymes (such as lipases)that hydrolyze such bonds. Furthermore, ester linkages can be prone tohydrolysis under alkaline conditions. The susceptibility of these andother cleavable bonds to these processes is dependent on the nature ofthe bond and the groups connected by it.

For those CAMP conjugates using a stable linkage, the attached drugwould still be effective when attached to the carrier peptide. As forthose CAMP conjugates using a cleavable linkage, the drug (i.e.,antimicrobial agent) tends to be released slowly through environmentalprocesses or through biological processes, such as through enzymesassociated with the targeted microbes (e.g., bacterial lipases).

To illustrate a specific example of developing an antimicrobialagent-peptide conjugate, reference is made to FIG. 3. In this model,peptides need to be first prepared and evaluated S305. The peptides maybe based on C-terminal portion of hBD-3. Then, an antimicrobial agentneeds to be selected S310. Here, levofloxacin is selected as the modelexample because of its potency and conjugation chemistry. However, itshould be noted that the present invention used levofloxacin only as anexample and thus is not limited to only this drug. Next, the conjugatemay be created by directly attaching levofloxacin molecules to amine andhydroxy groups present in the selected peptide via formation of amideand ester bonds, respectively S315. Afterwards, what needs to bedetermined are 1) whether free drug remained after workup of conjugate;2) the variation in drug loading; 3) antimicrobial potency; and 4)toxicity to host cells and hemolytic activity S320. If the results ofthese determinations are satisfactory, then the created antimicrobialagent-peptide conjugate (like the model levofloxacin-hBD-3 conjugate) isdeemed successful.

I. Peptides and Compounds

A. CAMPs

Cationic antimicrobial peptides (CAMPs) are essential elements of innateimmunity in higher organisms that contribute to the first line ofdefense against infection. While CAMPs exhibit a diverse range of aminoacid sequences and structural properties, they are typically smallamphipathic peptides that are rich in lysine and arginine residues. Inaddition, they exert a direct antimicrobial effect on a broad-spectrumof microbes, such as Gram-positive and Gram-negative bacteria, fungi andviruses.

Small antimicrobial peptides can be loosely classified into four groupsbased on common structural themes: (1) linear α-helical peptides, (2)linear extended peptides (with sequences dominated by one or more aminoacids), (3) peptides containing loop structures, and (4) peptides withmore defined structures constrained by intramolecular disulfide bonds.

Vertebrate defensins are small CAMPs that contain one or moreintramolecular disulfide bonds and can be grouped into defensinsub-families based on functional and structural properties.

The antimicrobial mechanisms employed by most CAMPs are believed toinvolve disruption of the bacterial membrane. In these models, thecationic peptides initially associate with the outer surface ofbacterial membranes, which tend to contain a greater abundance of lipidswith negatively charged head groups than do eukaryotic membranes.Moreover, the presence of cholesterol in eukaryotic membranes can makethem more resistant to disruption by CAMPs. While multiple membranedisruption schemes have been proposed, these mechanisms appear to bepeptide dependent. Generally, proposed membrane disruption mechanismsrange from a “barrel-stave” model to a “carpet model”. The“barrel-stave” model describes a model where amphipathic helicalpeptides insert into the membrane to form helical bundle structures thatcontain large central pores. The “carpet model” describes a model wherepeptides gather and concentrate at the membrane surface, interact withthe anionic lipid head groups, and cause distortions in the lipidbilayer and the formation of peptide-lined openings in the membrane.

B. Defensins

Defensins are a family of potent antimicrobial peptides produced byvarious types of cells in the body, including but not limited toneutrophils, macrophages, epithelial cells and leukocytes. These smallantimicrobial peptides are a major component of the first line ofdefense against invading pathogens. They are known to demonstrate broadantimicrobial activity against bacteria, fungi, parasites and viruses.Like other CAMPs, defensins are believed to function as least in part bybinding to microbial membranes and increasing membrane permeability ofthose microbes.

In mammals, there are three main families of defensins, namelyα-defensins, β-defensins and θ-defensins, that share some commonfeatures. They are generally rich in basic amino acid residues, such asarginine and lysine. In α-defensins and β-defensins, six cysteineresidues form three intramolecular disulfide bonds, stabilizing the 3Dstructure that contains a triple-stranded antiparallel β-sheet.α-defensins are produced primarily in neutrophils and small intestinalpaneth cells. β-defensins are produced in leukocytes and epithelialcells. The majority of work to date has focused on four distinct humanβ-defensins, namely human β-defensin-1 (“hBD-1”), human β-defensin-2(“bBD-2”), human β-defensin-3 (“hBD-3”) and human β-defensin-4(“hBD-4”). θ-defensins are short peptides, which are produced by rhesusmacaques. Unlike other defensins, θ-defensins are unique in that theyare cyclic peptides, where the N- and C-termini have been linked througha backbone peptide bond. Humans appear to possess a defective gene forθ-defensins, and they do not produce these peptides.

C. Beta-Defensins

Despite demonstrating limited sequence similarity, beta-defensins (asubclass of defensins expressed in mammals and birds) are characterizedby a shared three-dimensional folded conformation that combines anN-terminal α-helical segment and a small three-stranded antiparallelβ-sheet. In beta-defensins, the folded structure may be stabilized by aconserved network of three intramolecular disulfide bonds.Beta-defensins are predominantly expressed by epithelial cells. However,low-level expression of beta-defensins has been observed in othertissues, such as the heart and the thymus. Of the known humanbeta-defensins (hBDs), human beta-defensin-1 is constitutivelyexpressed, while the expression of other hBDs appears to be primarilyinduced by the presence of pathogens and pathogen associated compounds.To date, the majority of research has focused on hBD-1, hBD-2, hBD-3,and hBD-4. But analyses of human genomic sequences have revealed theexistence of five beta-defensin gene clusters containing approximately30 known and potential beta-defensin genes. These peptides demonstrateantimicrobial effectiveness against a broad spectrum of Gram-positiveand Gram-negative bacteria, fungi, and some enveloped viruses, withhBD-3 demonstrating broader antimicrobial effectiveness than the otherthree human beta-defensins. Additionally, the antimicrobial potencies ofhBD-1, hBD-2, and hBD-4 are negatively impacted by the ionic strength ofthe medium, while hBD-3 retains its antimicrobial activity even atelevated salt concentrations. While beta-defensins are capable ofdirectly exerting antimicrobial activity against invading pathogens,they also demonstrate chemotactic properties, thus bridging innateimmunity and adaptive immunity.

Recently, short peptides with sequences based on portions of the aminoacid sequence of hBD-3 have been reported to exhibit variedantimicrobial potencies against E. coli and S. aureus. FIG. 4 and FIG. 5illustrate the amino acid sequence of hBD-3. Regions residing in adefined secondary structure in the folded peptide are labeled “α” for“-helix” configuration and “β” for a “-strand” configuration. Residuescorresponding to the antimicrobially active decapeptide are denoted withthe expression “RGRKCCRRKK” (SEQ ID NO:4).

In these truncated peptides, serine residues may be substituted forcysteine residues present in the full-length peptide to eliminate thepotential of the formation of disulfide bonds. The shortest peptide thatdemonstrated significant antimicrobial potency is a decapeptide with asequence based on the C-terminal portion of hBD-3, namely Arg36-Lys45.In a broader context, this decapeptide represents one of the shorterpeptides that demonstrate significant antimicrobial activity. Moreover,it cannot be readily grouped with any of the structural classes as notedabove. In the folded full-length peptide, the segment corresponding to-Lys-Ser-Ser-Arg- provides the interior beta strand of the antiparallelbeta sheet. Outside of the context of the full-length peptide, it isunlikely that the corresponding residues in the decapeptide are in asimilar conformation as they are in the parent peptide. Furthermore, thedistribution of hydrophobic and hydrophilic residues within the peptidesequence is not consistent with the pattern that is normally associatedwith the formation of an amphipathic helix.

The fact that the decapeptide described above retains antimicrobialactivity in the absence of the remainder of hBD-3 makes it an appealingmodel for exploring the relationship between net charge, chargedistribution, and antimicrobial activity. To study these effects, aseries of peptides have been designed based on the decapeptide in orderto evaluate how these properties contribute to their antimicrobialpotency.

D. Nitric Oxide

Work conducted over the past two decades has established NO as a majorsignaling molecule with diverse physiological functions, includingneurotransmission, vasodilation, immune regulation and host defenseagainst pathogenic microorganisms. While the immunoregulatory functionsof NO are well documented, less is known about its antimicrobialfunction. Production of NO is associated with macrophage response toinfection. Being a reactive nitrogen species, NO demonstratesbroad-spectrum antimicrobial activity and is believed to exert itsantimicrobial activity by inflicting nitration damage and indirectlycauses oxidative damage to many microbial systems. It is generallybelieved that bacterial DNA and the DNA repair machinery are targets ofNO related damage. A variety of other proteins are also damaged in theprocess by nitration and oxidative damage.

The remarkable variety of bioregulatory roles that have been identifiedfor the nitric oxide radical has produced a need for compounds that canconveniently generate NO both for use in laboratory studies and aspotential drugs targeting delivery of NO to specific biological sites.Among several classes of NO donor compounds which have been developed,diazeniumdiolates (“NONOates”), ions of structure R¹R²N[N(O)NO]⁻, haveproven to be one of the most versatile and widely used. Diazeniumdiolatecompounds provide an excellent source for the controlled release of NO,both in vitro and in vivo. When dissolved in buffers or cell culturemedia, they undergo spontaneous acid catalyzed dissociations with wellbehaved first-order processes to release the parent amine andquantifiable amounts of NO.

Since their NO release rates have half-lives ranging from ˜2 seconds to˜20 hours, depending on the structure of the parent amine andsubstituents on the 0² position, they have proven to be a particularlyversatile class of NO providers. Their versatility can be extendedthrough O²-derivization of the —[N(O)NO]⁻ group to form diazeniumdiolateconjugates that do not release significant amounts of NO until theterminal substituent is removed by enzymes or other biological processesat targeted sites. Diazeniumdiolates have found application as NOreleasers in biomedical research studies exploring NO's vasodilatory,antiplatelet, and cytostatic properties.

As shown in FIG. 6, diazeniumdiolates are readily synthesized byreaction of a secondary amine with NO gas at 5 atm pressure to producesolids that are stable at 0° C.

The multiple roles NO plays in cell signaling and host defense have ledto considerable interest in potential therapeutic applications of NO andNO-releasing derivatives, such as diazeniumdiolates. The antimicrobialactivity of NO led to the incorporation of silicon aminoalkoxides in thesynthesis of sol-gels. The porous silica that was formed contained aminefunctionalities, which were in turn used to generate diazeniumdiolates.It was hypothesized that thin films of such materials would release NOunder physiological conditions, which would serve to prevent theformation of biofilms on the sol-gel surface. Such biofilms can bepersistent problems associated with catheters, artificial joints andother implants; often, they threaten the health of patients. Ultimately,it was determined that the nature of the silicon aminoalkanoate used informing the sol-gel influenced the rate of NO release and stability ofthe diazeniumdiolate. They also found that these materials were moreresistant to biofilm formation than were comparable materials that didnot contain diazeniumdiolates, illustrating the potent antimicrobialproperties of this class of compounds.

Two groups have reported distinct strategies for conjugatingdiazeniumdiolates to peptides or proteins. One set out to develop ageneral strategy for attaching diazeniumdiolate groups to peptides andproteins in order to take advantage of the unique functions of theproteins to direct delivery of the attached diazeniumdiolate. In thisapproach, a methoxymethyl-protected monodiazeniumdiolate of piperiazinewas conjugated to both human and bovine serum albumin utilizing anasymmetric linker, maleimidobutyric acid. The diazeniumdiolatederivative was attached to the protein by forming an amide bond betweenthe carboxyl group of the linker and the side chains of lysine residuesin the protein under conditions that allowed the protein remain folded.Another strategy was engineering a diazeniumdiolate-peptide conjugate inorder to target the prostate and metastatic prostate cancer.Diazeniumdiolates were conjugated to the C-terminus of the peptide viaand acetoxymethoxy linkage at the O² position of the diazeniumdiolate.By using a peptide with an amino acid sequence recognized by a prostatespecific antigen (PSA) with proteolytic activity, breakdown of thediazeniumdiolate and release of NO is initiated by hydrolysis of theC-terminal ester by PSA.

II. Antibiotic-CAMP Conjugates

Generally, constructs based on short antimicrobial peptides may beengineered for tile targeted delivery of antibiotics and cytotoxicagents. As illustrated in FIG. 7, this process can be achieved bycapitalizing on the ability of such peptides to specifically targetmicrobes largely due to electrostatic interactions between the cationicpeptides and the anionic surface of the bacterial membrane. Becausethese peptides generally target a fundamental physical property ofbacterial membranes, conjugates based on CAMPs should be effectiveagainst a broad spectrum of microbes, while leaving host cells unharmed.

The term “conjugate” refers to CAMPs with covalently attachedantibiotics and antibiotic-linker adducts (e.g., antibiotic-CAMPconjugate).

The term “adduct” refers to an antibiotic with a covalently attachedlinker segment (e.g., drug-linker adduct).

The main function of the peptide is not to directly kill the microbe,albeit destroying the microbe may be a beneficial side-effect. Instead,the main function is to have the peptide serve as a carrier andfacilitator for the delivery of one or more attached antimicrobialagents. Ideally, the antibiotic delivered by the conjugate would inflictantimicrobial activity against targeted bacteria at concentrationssignificantly lower than that required for the carrier peptide itself tokill them.

As one embodiment, referring to FIG. 8, drug moieties or drug-linkeradducts bearing carboxylic acid groups may be attached to a peptidecarrier via amide bonds formed with the primary amino groups of theN-terminus and lysine side chains in the peptide. This figureillustrates a scheme for conjugating antibiotics attached (dark circles)to the peptide carrier. The strategy involves activating a carboxylicacid group on the drug molecule or the linker to form amide bonds withfree amino groups present in the peptide. The performance of freepeptides and acetylated peptide derivatives can be evaluated using invitro antimicrobial, hemolytic and cytotoxicity assays to identifypotential peptide carriers and hone their targeting ability.

To initially evaluate the ability of peptides and their respectivederivatives to effectively target bacteria, antimicrobial potency of E.coli may be used. Similarly, hemolytic and cytotoxicity assays mayprovide a means of evaluating whether the peptides and their derivativesare likely to attack host cells.

Designing peptide carriers for maximum performance of fully-loadeddrug-peptide conjugates where all available sites of attachment areoccupied is essential for consistent performance. By focusing onfrilly-loaded conjugates, a homogeneous product may be created withouthaving to resort to complex and likely inefficient strategies forresolving various antibiotic-CAMP species that may be formed otherwise.

In other instances, a heterogeneous product may be produced. Forinstance, the levofloxacin conjugates that have been prepared areheterogeneous and comprise three different species that differ in thedegree of loading. For example, loading may occur in all of the Lysresidues and the N-terminus. As another example, loading may occur alongthe side chain —OH groups of serine residues.

Each lysine residue represents a site for attachment of drug groups. Aresult of attachment is a net loss in positive charge in the conjugatedpeptide, which may impact the targeting capacity of the deliveryvehicle. Therefore, variations in sequence focus primarily on the numberand position of lysine and arginine residues.

Not only does such focusing help refine the balance between charge andloading in antibiotic-CAMP conjugates, but also helps enhanceantimicrobial potency coupled, while minimizing hemolytic activity.

It should be noted that serine residues can be incorporated within thepeptide sequence to introduce hydroxyl groups. These hydroxyl groups canin turn be used to attach drug molecules through the formation of esterbonds. Such bonds may be more amenable to enzymatic cleavage than theside chain amide bonds formed with Lys residues.

To employ CAMPs and create CAMP-antimicrobial agent conjugates, threemajor aspects need to be considered. First, suitable carrier peptidesneed to be identified. As an embodiment, small cationic peptides withsequences based on naturally occurring antimicrobial peptides can beengineered to evaluate the ability of free peptide(s) as well as theconjugated peptide to target bacteria preferentially over host cells.Sequences can be varied to probe how the net charge, chargedistribution, degree of loading, nature of covalent attachment, andpositioning of substitution may impact the performance of the peptide.

Second, suitable antimicrobial agents need to be identified andconjugated. As one embodiment, antibiotics may be used as theantimicrobial agent to be delivered by the peptide carriers. As anotherembodiment, diazeniumdiolates and NO may be used. Diazeniumdiolates areversatile NO sources. As a nonlimiting example, the performance of amethoxymethyl-protected monodiazeniumdiolate of piperazine may beevaluated. The present invention also allows for other and additionaldiazeniumdiolate variants that may be used to improve and refineperformance of the free drug.

Third, conjugates should be evaluated and refined. As an embodiment,drug-peptide conjugates may be assembled. As another embodiment,diazeniumdiolate-peptide conjugates may be assembled. Their performancesmay be evaluated in antimicrobial hemolytic and cytotoxicity assays.This information may be used to direct the engineering of the nextgeneration of peptides and drug/diazeniumdiolates and conjugates. Theprocess may be repeated until a peptide-drug combination or apeptide-diazeniumdiolate combination is identified that embodies bothsuperior antimicrobial potency, and minimal hemolytic activity andcytotoxicity.

As one embodiment, the present invention uses constructs derived fromCAMPs, such as, but not limited to, human β-defensin-3, for the deliveryof antimicrobial agents. This coupling capitalizes on the CAMPs'abilities to specifically target microbes, which are in large part oftendue to electrostatic interactions between the cationic peptides and theanionic surface of the bacterial membrane.

Referring again to FIG. 7, drug-peptide conjugates which are positivelycharged, may be attracted to bacterial membranes. The outer surface ofbacterial membranes tends to be rich in lipids with negatively chargedhead groups. The electrostatic attraction allows for the attachedantibiotic moieties to be delivered to the microbe.

While the issue regarding the specific mechanism employed byantimicrobial peptides remains debatable and whether secondary targetsare involved, these peptides surprisingly attack bacterial membranes.Ultimately, such attack disrupts membrane integrity and kills themicrobe. Therefore, an added, surprising benefit of using deliveryconstructs based on antimicrobial peptides is their ability to weaken ordisrupt bacterial membrane integrity, which would facilitate entry ofthe associated antimicrobial agent. Moreover, the peptides may cross thebacterial membrane prior to disruption and may target groups within themicrobe. In this scenario, the peptide would carry the attachedantibiotic with them providing the ferried drug molecules access to theinterior space of the targeted microbe. The membranes of eukaryoticcells are generally more resistant to disruption than are bacterialmembranes. Higher resistance generally provides an added mechanism forthe targeted delivery of antimicrobial agents into the interior ofinvading microbes. By focusing on the bacterial membrane and nottargeting specific surface proteins, conjugates based on antimicrobialpeptides should be effective against a broad spectrum of microbes, whileleaving host cells unharmed. In this strategic embodiment, the mainfunction of the peptide is then not to directly kill the microbe.Rather, it is to serve as a carrier and facilitator for the delivery ofan attached antimicrobial agent.

Ideally, the antibiotic-CAMP conjugate and the delivered antibiotic mayexert antimicrobial effect at concentrations that are significantlylower than that required for the peptide along to kill the microbe(s).

A. Identification of Suitable Carrier Peptides

As an embodiment, the present invention may use small peptides. Thesesmall peptides may be based on, for instance, the amino acid sequence ofthe C-terminal region of the potent antimicrobial peptide hBD-3.

Short peptides (about 14- to about 10-residues) based on this region ofhBD-3 have been reported to be potent against E. coli, with EC₉₀'sranging from 1-10 μg/ml. These peptides generally provide an excellenttemplate for engineering small antimicrobial peptides to serve ascarriers. They contain multiple lysine and arginine residues.Additionally, they provide a high degree of control over the degree ofloading and sites of attachment through the exchange of lysine andarginine residues in the sequence. The relatively small size of thesepeptides makes them more synthetically accessible than largerantimicrobial peptides. Furthermore, it tends to make them better suitedto serve templates for future designs of peptide mimetics for improvedrobustness in vivo.

The initial peptide (Peptide-1 or Pep-1) and three sequence variants maybe designed to evaluate how attachment of drug moieties throughacylation and the associated loss in positive charge may affect activityand elucidate design criteria for minimizing impact.

The sequence of Peptide-1 may be denoted as (RGRKSSRRKK) (SEQ ID NO:2).This ten-residue peptide is based on the C-terminal region of hBD-3. InPeptide-1, serine residues may be used in place of cysteine residuespresent in the parent hBD-3. Reportedly, Peptide-1 is known todemonstrate antimicrobial potency at concentrations as low as 4 μg/ml.Fully acylated, this peptide may have a net charge of about +3 at pH ofabout 7 (as compared to +7 for the unmodified peptide).

The three sequence variants of Peptide-1 may be respectfully referred toas Peptide-2 (also Pep-2), Peptide-3 (also Pep-3), and Peptide-4 (alsoPep-4).

Peptide-2 may have a sequence denoted as (RGRRSSRRKK) (SEQ ID NO:3).Here, Lys-4 of Peptide-1 has been replaced with an Arg residue. Thisreplacement acts as a conservative substitution that can effectivelyeliminate a site that could be acetylated. Moreover, such generallyhelps retain the basic character of the position. Fully acylated, thispeptide may have a net charge of about +4 at a pH of about 7 (ascompared to +7 for the unmodified peptide).

Peptide-3 may have a sequence denoted as (RGRKSSRRKK-NH₂) (SEQ ID NO:5).Here, the C-terminal carboxyl group of Peptide-1 has been blocked byforming the C-terminal amide. This blockage eliminates the only acidicgroup in the peptide. Fully acylated, this peptide may have a net chargeof about +4 at a pH of about 7 (as compared to +8 for the unmodifiedpeptide).

Peptide-4 may have a sequence denoted as (RGRRSSRRKK-NH₂) (SEQ ID NO:6).This peptide combines both the sequence modifications present inPeptide-2 and Peptide-3. Thus acylated Peptide-4 may have a +5 charge ata pH of about 7 (as compared to +8 for the unmodified peptide).

Peptides used may be custom synthesized by a number of companies (suchas CelTek Bioscience, LLC of Nashville, Tenn. or Peptides International,Inc. of Louisville, Ky.) and/or by using various protocols. For example,fitly acetylated derivatives of the peptides may be prepared bydissolving the unmodified peptides in 50 mM ammoniumbiocarbonate,followed by adding a methanolic solution of acetic anhydride. Using thisprotocol, which may be found the website of IonSource, LLC, the degreeof acetylation for each peptide may be determined by MALDI-TOF massspectrometry.

As another protocol example, these peptides may be manually synthesizedusing standardized solid-phase peptide synthesis (“SPPS”) and9-fluoroenylmethoxycarbonyl (“Fmoc”) chemistry. Fmoc chemistry is anamine protection strategy that may be incorporated to prevent unwantedreactions at the α-amino group of the residue. In other words, theα-amino groups on amino acids may be provided temporary protection asthey are being coupled. Another example of peptide synthesis includesSPPS based on t-butoxycarbonyl (“Boc”) chemistry, which is another amineprotection strategy.

The antimicrobial activities of the peptides and their acetylatedderivatives may be assessed using K-12 E. coli and assays based on anexisting protocol used to study derivatives of hBD-3. The bacteria maybe grown to mid-log phase in Luria Bertani (LB) broth. Aliquots of theculture may then be diluted (to a cell density of about 10⁶ CFU/ml) into10 mM sodium phosphate at a pH of about 7.5. Each of the aliquots maycontain varied concentrations of peptide or acetylated peptide. Thediluted bacterial cultures may then be incubated for about 2 hours at atemperature of about 37° C. After the proscribed time, serial dilutionsof the assay cultures may be plated onto LB agar plates, and thenallowed to incubate overnight at a temperature of about 37° C. Afterincubating, colonies may be counted. Dose-response curves may beprepared to calculate EC₅₀'s. Results of these experiments are shown inFIG. 9. Past A of this figure shows antimicrobial activity (EC₅₀) forpeptides and their acetylated derivatives. Part B of this figure shows agraph illustrating relationship between antimicrobial activity andnominal peptide charge at pH7.

Part B also demonstrates that going from a formal charge of about +8 toabout +5 results in only a slight decrease in potency. However, peptideswith a charge of about +5 appear to be significantly more potent thanthose with a charge of about +3. To determine whether this trend relatesto the correlation between the formal charge and performance ofantibiotic-CAMP conjugates, it may be helpful in performing similarstudies using antibiotic-CAMP conjugates.

Hemolytic activity may be assayed by, for example, incubating horseerythrocytes (e.g., Hemasource Inc. of Eugene, Oreg.). Varied peptideconcentrations in phosphate buffered saline (e.g., Cellgro, produced byMediatech, Inc. of Manassas, Va.) may be used for the incubationprocess. Hemolysis may be quantified by pelleting cells after incubationusing centrifugation, and then measuring the absorbance of thesupernatant at about 540 nm. As shown in FIG. 10, hemolytic datasuggests that Peptide-1, Peptide-2, and Peptide-4 may show somelow-level hemolytic activity at very high concentrations. However, noneof the acetylated peptides appear to demonstrate hemolytic activity(less than 1%).

While the results shown in FIG. 10, suggest that the acetylated peptidestarget bacteria and leave the erythrocytes unharmed, it may be necessaryto similarly evaluate the hemolytic activity of the antibiotic-CAMPconjugates. The attached drugs may likely have significantly greaterimpact on the physical properties of the peptides than do acetylation.Here, performance in hemolytic and antimicrobial assays may be used togauge specificity in targeting. To address the larger problem ofpotential toxicity, peptides and conjugates need to be subjected tocytotoxicity studies.

Similarly, in experiments between Peptide-1 and Peptide-4, BL21(DE3)cells were also used. Results from these experiments are shown in TABLE1.

TABLE 1 Antimicrobial activity (LC₉₀) for peptides and their acetylatedderivatives LC₉₀ (μg/ml) Peptide Free Peptide Acetylated Peptide*Peptide-1 2.23 94.40 Peptide-4 0.15 1.49 The “*” denotes antimicrobialactivities of acetylated peptides, which are based on results of singledataset, while values for the free peptides are calculated fromtriplicate data.

As can be seen, the increased positive charge of Peptide-4 resulted inincreased antimicrobial activity relative to Peptide-1. Moreover, likethe above experiments, acetylation of Peptide-4 resulted in a smallerdecease in antimicrobial activity relative to Peptide-1. In fact, thepotency demonstrated by acetylated Peptide-4 with a net charge of +5 iscomparable to that of the parent peptide (Peptide-1), which has a chargeof +7. This closeness suggests that the antimicrobial potency is notsolely the result of net positive charge. It also reflects distributionof charge, as well as possibly subtle influences associated with theacetylation of lysine side chains.

These peptides (Peptide-1, Peptide-2, Peptide-3 and Peptide-4) and theiracetylated derivatives are intended to probe the significance of charge,degree of substitution and the C-terminal carboxyl group as they relateto the performance of the peptide and analogous antibiotic-CAMPconjugates. Peptide-2 and Peptide-3 serve as intermediates betweenPeptide-1 and Peptide-4 and are further intended to isolate theinfluence of the C-terminal carboxylic group in the antimicrobialactivity of the acetylated/acylated peptide.

The performance of these peptides and their acetylated derivativesagainst K-12 E. coli in antimicrobial assays have provided insights intohow the charge of the acetylated peptide impacts its potency and howgreat a loss of charge may be accommodated without compromising potency.It is also significant to note that none of the free or acetylatedpeptides demonstrate significant hemolytic activity, which suggests thatit may be possible to engineer drug-peptide conjugates that specificallytarget invading bacteria using these peptides as carriers. Therefore,antibiotic-CAMP conjugates may be prepared that incorporate thesepeptides and either chloramphenicol or levofloxacin. Furthermore, thecytotoxicity of the peptides and their derivatives may be determinedusing cultured hepatocytes and measuring the release of lactatedehydrogenase. This measurement may be achieved by using, for example,the Cytotox96 kit (by Promega Corp. of Madison, Wis.), which is a wellestablished method of measuring cytotoxicity. Antimicrobial studiesusing these peptides and their derivatives may be expanded to includenonvirulent or attenuated strains of Francisella tularensis, Bacillusanthracis, Pseudomonas aeruginosa and Vibrio cholera, among others asmodels for the disease causing organisms.

Furthermore, the performance of these peptides (Peptide-1, Peptide-2,Peptide-3 and Peptide-4) and their derivatives may be used in the designof a second generation of peptides employing the design criteria asdescribed above. The performance of the antibiotic-CAMP conjugates mayalso be incorporated in the design process. In turn, the design processmay be repeated with successive generations of peptides and peptideconjugates. Should none of the peptide conjugates based on Peptide-1,Peptide-2, Peptide-3 and Peptide-4 exhibit satisfactory antimicrobialactivity against the selected panel of microbes or pass the hemolyticand cytotoxicity assays, it may be necessary to explore usingalternative peptide scaffolds, such as full-length β-defensins orcathelicidins. The β-defensin or cathelicidin would provide the basisfor the design of new smaller peptides to identify minimal elementsrequired to generate conjugates that demonstrate satisfactoryantimicrobial activity and minimal hemolytic activity.

B. Identification and Conjugation of Antimicrobial Agents

1. Chloramphenicol and Levofloxacin

As an embodiment, antibiotic-CAMP conjugates incorporate chloramphenicoland levofloxacin. Both are broad-spectrum antibiotics whose molecularstructures contain functional groups that allow their attachment tolinker segments through the formation of an ester bond, providing forthe release of the drugs by hydrolysis of the ester bond. Additionally,the linker segment supplies a way of affixing the drug-linker adduct tothe delivery vehicles through the acylation of primary amino groups(e.g., on the N-terminus and Lys side chains) present on the peptides.Alternatively, levofloxacin may be directly attached to the deliverypeptide through the acylation of primary amino groups and hydroxylgroups (i.e., Ser side chains) present in the peptide.

Reaction conditions, such as reaction times, solvents and stoichiometrycan be optimized to maximize yield and purity. These antibiotics may beused in the first generations of drug-peptide conjugates to evaluate andrefine conjugate performance.

a. Chloramphenicol

Chloramphenicol is a well-characterized antibiotic with precedent forits conjugation to filamentous phage for specific targeting ofStaphylococcus aureus. The drug exerts a bacteriostatic effect againstboth gram-positive and gram-negative bacteria by binding to the 50Sribosomal subunit and inhibiting protein biosynthesis. Chloramphenicolis relatively hydrophobic and attachment of Chloramphenicol to thecarrier peptide can significantly alter its overall character andselectivity in targeting. Therefore, the degree of loading andpositioning of attachment points may be important for the performance ofchloramphenicol-peptide conjugates.

Referring to FIG. 11, the chloramphenicol-linker adduct may be preparedusing a known protocol. In this process, chloramphenicol and a molarexcess of glutaric anhydride are dissolved in a minimal volume ofanhydrous tetrahydrofuran. A molar excess of triethylamine and acatalytic amount of dimethylaminopyridine are then added to thesolution. The reaction can then be allowed to stir under nitrogenovernight at room temperature. The desired adduct is isolated from thereaction mixture by flash chromatography.

b. Levofloxacin

Levofloxacin is a third generation fluoroquinolone antibiotic that iseffective against both gram-positive and gram-negative bacteria. Likeother fluoroquinolones, such as ciprofloxacin, levofloxacin is usuallybactericidal exerting antimicrobial effect by binding DNA gyrase andtopoisomerase IV and interfering with DNA replication. While there is noprecedent for the conjugation of levofloxacin to peptides and proteins,the carboxyl group present in levofloxacin provides a convenient way forconjugation. Unlike chloramphenicol, the N-substituted piperazine grouppresent in levofloxacin provides two protonatable tertiary amino groups,which may help to offset the loss of primary amino groups on the peptidecarrier, which is associated with drug conjugation.

As shown in FIG. 12, levofloxacin may be directly attached to thepeptide via its carboxylic acid group and direct acylation of amino andhydroxyl groups present in the peptide. Such process involves fewersynthetic and purification steps than would be required for the strategydescribed below, which involves the use of a linker. It may also avoidthe need for isolation of the conjugate by chromatographic methods.

Alternatively, a strategy could be employed where the levofloxacinmolecule is connected to the peptide via a linker segment. As shown inFIG. 13, assembly of the levofloxacin-linker adduct is a two-stepprocess. In the first synthetic step, 1,3-propanediol may be affixed tothe carboxylic acid of levofloxacin. This affixation may be accomplishedby preactivating the carboxyl group using N,N′-dicyclohexylcarbodiimide(DCC) and hydroxysuccinimide. The activated levofloxacin may then becombined with a large molar excess of 1,3-propanediol, triethylamine,and a catalytic amount of dimethylaminopyridine. This combination isallowed to stir under nitrogen, with progress of the reaction beingmonitored by reversed-phase high performance liquid chromatography(HPLC). Once the reaction has reached completion, thelevofloxacin-linker adduct can then be assembled with the addition of aglutarate group using reaction conditions similar to those described forgenerating the chloramphenicol-linker adduct.

c. Conjugation

Antibiotics bearing carboxyl groups or other suitable functional groupsmay be attached directly to the carrier peptide via acylation. Withsimple and unstructured peptides, it may be possible to preactivatecarboxyl groups on the drug molecules and carry out the acylationreaction in organic solvents (such as dimethylformamide) instead ofaqueous conditions, which may improve conjugation efficiency.

Alternatively, the antimicrobial agent may be connected to the peptidevia antibiotic-linker adducts. In such cases an antibiotic-linker adductmay need to be prepared. If so, once the antibiotic-linker adducts havebeen prepared, they may be conjugated to antimicrobial peptides. Inconjugating the adducts to the peptide, the carboxylic acid of thelinker is initially activated by forming the succinimido-ester. Thesuccinimido-ester may be generated by treating the antibiotic-linkeradduct with DCC in the presence of a molar excess ofN-hydroxysuccinimide. Reaction completion can be monitored by thin-layerchromatography or reversed-phase HPLC.

After the reaction is completed, the reaction mixture may be filtered toremove the dicyclohexyl urea byproduct that is formed in the course ofthe reaction. If necessary, the activated antibiotic-linker adduct maybe purified by flash chromatography. This type of strategy is common forforming activated esters that may be used to couple with peptides andproteins under mild aqueous conditions.

The antibiotic-linker adducts may be conjugated to free amino groups onthe carrier CAMP using known protocols for the coupling ofchloramphenicol to filamentous phage. The peptide may first be dissolvedin aqueous buffer (at a pH of about 8.5). A molar excess of theactivated antibiotic-linker adduct may then be dissolved in a minimalvolume of tetrahydrofuran, dimethylsulfoxide, or other water miscibleorganic solvent. The solution containing the activated antibiotic-linkermay then be added to the aqueous peptide solution. The conjugationreaction may be allowed to stir at room temperature with progress of thereaction monitored by reversed-phase HPLC.

It may be necessary to alter reaction conditions (such as solvent,coupling reagent, temperature, and drug/peptide stoichiometry) tomaximize conjugation efficiency. A greater molar excess of antibioticand coupling reagent or longer reaction times may also be required toachieve efficient loading.

As a representative protocol, the following example describes how aconjugate can be formed through direct acylation and subsequently bepurified. In this example, a levofloxacin conjugate is formed. Areaction vessel may be dried in an oven for ˜30 minutes and then allowedto cool to room temperature under nitrogen.Tetramethylfluoroformamidinium hexafluorophosphate (TFFH, 36.5 mg, 0.23mmol) and levofloxacin (50 mg, 0.14 mmol) are weighed and subsequentlydissolved in dry dimethylformamide (DMF, 200 μl). The solution istransferred to the dry reaction vessel, and the mixture is allowed tostir under nitrogen at room temperature. A catalytic amount ofN,N-dimethylaminopyridine (DMAP) is then added to the solution followedby 4-methylmorpholine (60 μl, 0.54 mmol). Additional DMF (˜500 μl) isadded to dissolve any solids that may be present and the activationreaction allowed to stir at room temperature under nitrogen for ˜1 hour.After which, the reaction is charged with peptide (Peptide-4, mw 2190g/mole as TFA salt, 2 mg, 0.00091 mmol), and allowed to stir overnightat room temperature under nitrogen. The following morning, the reactionmixture is diluted into diethyl ether (50 ml), and the resultingprecipitate pelleted by centrifuging at 5000 RPM for 10 minutes. Thesupernatant is removed and the pelleted material transferred to a 1.5 mlmicrocentrifuge tube. Residual ether is then removed using a speed-vac.The dried pellet is then resuspended in water (1 mL) and then pelleted.The supernatant is collected. The pelleted material is again suspendedin water (1 mL) and centrifuged. The supernatant from the second iscombined with the first and the solution is dialyzed (1000 MWCOmembrane) with water (3 L) at 4° C. for two days. Over the two dayperiod, the dialysate is changed twice times. After dialysis the sampleis lyophilized to dryness and stored at −20° C. until used orcharacterized.

The degree of conjugation may be evaluated by MALDI-TOF massspectrometry. An example of MALDI-TOF spectra of levofloxacin conjugatesis depicted in FIG. 14. The molecular weight for the number oflevofloxacin groups can be summarized as follows: 1285.5 for 0levofloxacin groups; 1628.87 for 1 levofloxacin group; 1972.24 for 2levofloxacin groups; 2315.61 for 3 levofloxacin groups; 2658.98 for 4levofloxacin groups; and 3002.35 for 5 levofloxacin groups.

Conjugates containing 4 or 5 levofloxacin molecules reflect acylation ofSer residues, as well as the Lys residues and the N-terminal aminogroup. In addition, analysis of prepared levofloxacin-peptide conjugatesfor the presence of free levofloxacin using HPLC, along with referencelevofloxacin concentrations are shown in FIG. 15. This data indicatesthat no significant amounts of free levofloxacin are present in theprepared conjugate.

The performance of levofloxaein-Peptide-4 conjugates prepared asdescribed above have been evaluated against K-12 E. coli. In theseassays, it was found that the Peptide-4 conjugates demonstrated animpressive EC₅₀ of 0.042 μg/ml, which represents a potency of ˜30×thatof the unmodified peptide, as determined earlier. The results of theseassays are given in FIG. 16.

As for the assay conditions used for the conjugate: the E. coli and theconjugate were incubated in LB. The potencies reported for the parentpeptide (Peptide-4) were determined by incubating the bacteria and thepeptide in 10 mM phosphate. The latter conditions represent a much moreideal environment for CAMP antimicrobial effectiveness than that used inevaluating the conjugate. Thus the actual superiority in the potency ofthe conjugate over the free peptide is likely much greater than theobserved 30 fold increase.

2. Diazeniumdiolates and Conjugation

Diazeniumdiolate-peptide conjugates can be created using themethoxymethyl-protected monodiazeniumdiolate of piperazine, as shown inFIG. 17, as the NO source. Synthetic procedures, by which thebifunctional amine piperazine can be used for attaching thediazeniumdiolate functional group into a variety of biomedically usefulmolecules, have been previously described. A derivative of thisdiazeniumdiolate was conjugated to human and bovine serum albumin usingan asymmetric maleimidobutyric acid linker. A similar approach can beused to conjugate diazeniumdiolate groups to the proposed peptidecarriers. In this approach, the monodiazeniumdioloate of piperazine islinked to maleimidobutyric acid to produce the diazeniumdiolate acid(Dda,) shown in FIG. 18. Activation of the carboxylic acid by formingthe succinimido ester (Dda-OSu) allows for the diazeniumdiolate group tobe conjugated through the acylation of primary amino groups present onthe unprotected peptide under mild conditions.

Dda may be incubated in phosphate buffer (at a pH of about 7) todetermine its stability to these conditions. Similarly, Dda stabilitymay be evaluated under antimicrobial and hemolytic assay bufferconditions. NO release may be monitored during antimicrobial andhemolytic assays to determine whether cellular processes result inaccelerated release of NO in either free Dda or the Dda-peptideconjugates.

In these experiments, the breakdown and release of NO may be monitoredusing standard spectrophotometric oxyhemoglobin assays, where changes tothe Soret band (at about 401 nm) are used to detect the NO-mediatedconversion of oxyhemoglobin to methemoglobin. This method is generallyused for the quantitative detection of NO at micromolar levels.

Initial antimicrobial activities of the Peptide-1 have been evaluatedagainst E. coli BL21(DE3). The antimicrobial activities of freepeptides, diazeniumdiolates, and diazeniumdiolate-peptide conjugates maybe evaluated against selected microbes, such as K-12 E. coli,Staphylococcus aureus, and Shigella dysentariae. The work represented incurrent literature and the present invention's results indicates thatthe parent peptide demonstrates good antimicrobial activity against E.coli, but may be less potent against other microbes, such asStaphylococcus aureus, F. tularensis, and A. actinomycetemcomitans. NOhas been reported to be potent against Staphylococcus aureus, butpossibly not as effective against E. coli. Therefore, these microbes mayprovide a way of evaluating the performance of the conjugate withrespect to both components, the peptide and the diazeniumdiolate.Shigella dysentariae has been included to evaluate the performance ofthe conjugates against an actual enteric pathogen.

C. Evaluation and Refinement of Conjugates

To gain basic insights into how performance of the peptides relates tothat of the corresponding antibiotic-CAMP conjugates, the firstgeneration of chloramphenicol and levofloxacin conjugates may beprepared utilizing all four of the initial peptides (Peptide-1,Peptide-2, Peptide-3 and Peptide-4). These conjugates may be subjectedto the full battery of antimicrobial, hemolytic, and cytotoxicity assaysto evaluate their performance, which in turn may be compared to that ofthe free and acetylated peptides and the free drugs.

The performance of the first generation of antibiotic-CAMP conjugatesand the insights gained from their analysis may be utilized in thedesign of the next generation of free peptides to be evaluated. Thefollowing generations of conjugates may be generated based on thosesecond-generation peptides that demonstrated superior performance in theantimicrobial, hemolytic and toxicity assays as both the free peptidesand acetylated derivatives. This process may be repeated, each limeselecting for those peptides and antibiotic-CAMP conjugates thatdemonstrate superior performance. Due to differences in the physicalproperties of different antibiotics, it may be necessary to considereach one separately in the revision process.

In addition to evaluating the antimicrobial potency of theantibiotic-CAMP conjugates, the release of free drug from the conjugatesunder conditions used in the various activity assays may also beevaluated. Conjugates may be incubated in water, phosphate bufferedsaline, and the buffers used in the antimicrobial, hemolytic andcytotoxicity assays. Drug release may be monitored by HPLC or LC-MS.Drug release may also be monitored under actual assay conditions. Theresults of these studies may be correlated with the performance of theconjugate in antimicrobial, hemolytic and cytotoxicity assays. Theinformation provided by these drug-release studies may be utilized inthe design of future conjugates, with a particular focus on the natureof the bond that connects the drug to the peptide and/or to the linkersegment, if present, as well as the nature of the linker segment (if oneis used). Whether linker segments are present or are being used, thetinkers can be long (e.g., succinate) or short (e.g., glutarate). Also,ester bonds may be used in place of amid bonds to achieve this goal.

An advantage of the proposed antibiotic-CAMP conjugate strategy is thatit employs a modular approach to assembling the conjugate, This approachtends to allow significant flexibility and the ability to adjust theconstructs in response to their performance in the various assays.

III. Experiments

In one embodied experiment, the materials used include peptides thatwere custom synthesized by CelTek Bioscience, LLC (Nashville, Tenn.) orby Genscript Corporation (Piscataway, N.J.) using Fmoc chemistry, K12 E.coli, ATCC #25404 (American Type Culture Collection, Manassas, Va.), andhorse erythrocytes (Hemasource, Inc., Eugene, Oreg.). Mass-spectra maybe collected on a prOTOF 2000 (PerkinElmer, Inc., Waltham, Mass.).

A. PEPTIDE ACETYLATION

Acetylation reagent may be prepared by combining ˜200 μl of aceticanhydride with ˜600 μl of methanol. Using any of the above describedpeptides, the peptide (˜2-˜2.5 mg) may be reconstituted in −200 μl of˜50 mM ammonium bicarbonate buffer. About 500 μl of the acetylationreagent may then be added to the peptide solution. The reaction may beleft at room temperature for about 1 hour. Methanol and unreacted aceticanhydride may then be removed with the aid of a speed-vac. The remainingaqueous solution may then be lyophilized to dryness.

In the case of each peptide, analysis of the resulting solid byMALDI-TOF may indicate that the isolated material consisted of fullyacetylated peptide, without detectable amounts of intermediateacetylated species being present. This protocol is based on a protocolreported by IonSource for the acetylation of peptides and proteins.

B. ANTIMICROBIAL ACTIVITY ASSAY

The antibacterial activities of the free and acetylated peptides may bedetermined using K12 E. coli and a known assay protocol. Bacteria may beincubated in Luria Bertani broth at 37° C. until reaching an OD₆₀₀ of˜0.8-˜1.1. Cell density may be monitored using optical density at 600nm. Cells were then diluted to a concentration of 10⁶ CFU/ml in ˜10 mMsodium phosphate (pH ˜7.5), containing varied concentrations of peptideor acetylated peptide. Peptide concentration used in the assays mayrange from 0 μg/ml to ˜100 μg/ml with intermediate concentrations variedfor each peptide in order to maximize the number of data points in ornear the transition region.

Assay cultures may be incubated at 37° C. for about two hours.Afterwards, serial dilutions of each assay culture may be prepared andthen plated in triplicate onto Luria Bertani broth plates. The platesmay be incubated at 37° C. overnight (˜16 h). Colonies may be countedthe following morning.

Bacterial survival at each peptide concentration may be calculatedaccording to the ratio of the number of colonies on the platescorresponding to the peptide concentration and the average number ofcolonies observed for assay cultures lacking peptide. The peptideconcentration required to kill ˜50% of tile viable E. coli in the assaycultures (EC₅₀) may be determined by plotting percent survival as afunction of the log of peptide concentration (log μg/ml) and fitting thedata, using GraphPad Prism (GraphPad Software, Inc., San Diego, Calif.),to Equation (1), which describes a sigmoidal dose-response.

$\begin{matrix}{S = {S_{B} + {\frac{\left( {S_{T} - S_{B}} \right)}{1 + 10^{{({{LogEC}_{50} - X})}H}}.}}} & (1)\end{matrix}$

In Equation (1), S is percent survival, S_(T) and S_(B) represent theupper and lower survival boundaries, X is the log of the peptideconcentration, and H is the Hill slope of the transition region. Resultsof these assays are given in FIG. 19 and TABLE 2.

In particular, FIG. 19 plots bacterial survival as a function of free oracetylated peptide concentration (log μg/ml) for each peptide andacetylated derivative.

TABLE 2 Antimicrobial potency for each peptide and acetylated peptideagainst E. coli. Antimicrobial Activity (EC₅₀, μg/ml) Peptide Free*Acetylated* Pep-1 2.4 (2.2-2.7) ~40^(‡) Pep-2 1.2 (1.1-1.3) 8.1(6.5-9.9) Pep-3 1.2 (1.1-1.2) ~70^(‡) Pep-4 1.5 (1.4-1.6) 4.9 (4.2-5.8)The EC₅₀ values for each derivative in TABLE 2 may be determined byfitting data into Equation 1. The symbol “*” denotes values, given inparentheses, that fall in the 90% confidence range. The symbol “^(‡)”denotes estimated EC₅₀ values for acetylated Pep-1 and acetylated Pep-3;no error range is given.

In fitting the data for all peptides and acetylated peptides (exceptacetylated Pep-1 and acetylated Pep-3), S_(T) and S_(B) may berestricted to values ≦100% and ≧0% respectively. For acetylated Pep-1and acetylated Pep-3, the absence of data points defining the lowerboundary necessitated that S_(B) be set to 0% in order to fit the datato Equation (1) and provide an estimated EC₅₀ for these peptides.

C. HEMOLYSIS ASSAY

Hemolytic activities of the free and acetylated peptides may bedetermined using horse erythrocytes, in an assay adapted to a microtitreplate format. Cells may be prepared by centrifuging ˜1 ml of horseerythrocytes at 1620×g, and then resuspending the pelleted cells in ˜1ml of 1× Dulbecco's phosphate-buffered saline (Dulbecco's PBS,Mediatech, Manassas, Va.). The cells may then be pelleted again. Theprocess may be repeated (e.g., three more times). Following the finalwash, the cells may be resuspended in ˜0.750 ml of PBS. Approximatelytwo hundred microliters of washed erythrocyte suspension may then bediluted into ˜9800 μl of PBS to afford about 2% suspension. Aliquots ofsterile water, peptide, and Dulbecco's PBS may then be combined in thewells of a 96 well microtitre plate so as to provide a gradient ofpeptide concentrations (0, ˜0.1, ˜1, ˜10, ˜100, and ˜1,000 μg/ml), towhich the ˜2% erythrocyte may be added. The assay solutions may then beincubated at 37° C. for ˜1 hour. An additional ˜100 μl of phosphatebuffer may then be added to each well. The microtitre plate may becentrifuged at 1000×g for about 2 minutes to pellet cells and debris. Analiquot of supernatant (−150 μl) from each well may then be transferredto a fresh microtitre plate, and the absorbance at ˜540 nm (heme) may beobtained for each solution. The percent hemolysis may be calculatedbased on the ratio of the absorption of supernatants from wellscontaining peptide and the absorption of supernatants from wellscontaining no peptide. In both cases, the recorded absorption may beadjusted for the background absorption of the plates.

D. EXPERIMENTAL RESULTS

Referring to TABLE 3, a series of peptides has been designed to test theeffect of net charge and charge distribution on antimicrobial activity.In particular, the table shows aligned amino acid sequences of Pep-1,Pep-2, Pep-3, and Pep-4. The Pep-1 variant is equivalent to thedecapeptide described in current literature. In the Pep-2 variant, anArg residue has been substituted for Lys4. In the Pep-3 variant, theC-terminal carboxyl group of Pep-I has been replaced with a carboxamidegroup, which effectively eliminates the only acidic group in thepeptide. The Pep-4 variant combines both sequence changes.

The underlined residues indicate the serine residues that have beensubstituted for the cysteine residues present in the hBD-3 parentsequence. The substituted arginine residue at the fourth position in thesequences of Pep-2 and Pep-4 is in bold. Similarly, the C-terminalcarboxamide in Pep-3 and Pep-4 is indicated by the italicized “—NH₂”.Nominal charges for the free and acetylated peptides at a pH of 7 arealso given.

TABLE 3 Aligned Amino Acid Sequences Charge at pH = 7 PeptideAmino Acid Sequence Free Acylated Pep-1 RGRKSSRRKK (SEQ ID NO: 2) +7 +3Pep-2 RGRRSSRRKK (SEQ ID NO: 3) +7 +4 Pep-3 RGRKSSRRKK-NH² (SEQ ID NO: 5) +8 +4 Pep-4 RGRRSSRRKK-NH ² (SEQ ID NO: 6) +8 +5

Acetylated derivatives of all four peptides may be prepared to expandand evaluate the range of peptide net charges and charge distributions.Unlike the majority of CAMPs, the Pep-1 sequence does not containstrongly hydrophobic residues, such as leucine, isoleucine, valine,tryptophan, or phenylalanine. However, the side chains of lysine andarginine residues themselves are amphipathic, with positively-chargedamino and guanidino groups, respectively, tethered to the peptidebackbone by aliphatic chains. Acetylation of the primary amino groupspresent in the peptides, specifically the N-terminus and ε-amino groupsof lysine residues, provides a means of neutralizing the chargeassociated with these groups, while retaining the hydrophobic and stericproperties of the side chains of Lys residues. Therefore, acetylatedderivatives of the four peptides may be prepared to further evaluate howpositively-charged groups may contribute to potency in these smallantimicrobial peptides.

The antimicrobial potencies of the free and acetylated peptides may beevaluated using K12 E. coli and plotting bacterial survival as afunction of peptide concentration. FIG. 19 highlights this graphicalrepresentation. Here, the antimicrobial activity for Pep-1, Pep-2,Pep-3, Pep-4, and their acetylated derivatives is illustrated byplotting bacterial survival as a function of free or acetylated peptideconcentration (log μg/ml) for each peptide and acetylated derivative.

EC₅₀ values for each peptide and peptide derivative may be calculated byfitting data to Equation (1), which defines standard sigmoidal doseresponse behavior. This equation allows for a variable Hill slope.

The unmodified peptides demonstrated similar antimicrobial potencies,with free Pep-1 being slightly less potent than Pep-2, Pep-3, and Pep-4.This trend may be reflected in the calculated EC₅₀ values for the freepeptides. As indicated in TABLE 2, Pep-2 and Pep-3 each may have an EC₅₀of −1.2 μg/ml, and Pep-4 may have an EC₅₀ of ˜1.5 μg/ml. The 95%confidence ranges associated with each of these values tend to suggestthat the differences in potency between Pep-1 and the other freepeptides likely reflect actual differences in potency. The acetylatedpeptides demonstrated more varied potencies, consistent with the largerrange of charges (+5 to +3). Acetylated Pep-4 with a charge of +5 mayhave an EC₅₀ of −4.9 μg/ml, and acetylated Pep-2 with a charge of +4 mayhave an EC₅₀ of ˜8.1 μg/ml, making them only slightly less potent thanfree Pep-1 (˜50% and ˜25%, respectively).

However, acetylated Pep-1 and Pep-3 may demonstrate detectableantimicrobial activity only at very high peptide concentrations. Neitheracetylated peptide killed more than ˜80% of bacteria within the range ofevaluated peptide concentrations. Therefore, the EC₅₀ values given foracetylated Pep-1 and Pep-3 (˜39 μg/ml and ˜70 μg/ml, respectively)generally represent estimated values. Significant error is associatedwith both.

Referring to FIG. 20, the importance of positive charge, as well as itsimpact on antimicrobial potency, is evident when EC₅₀ values are plottedas a function of peptide charge. This figure shows antimicrobial potency(EC₅₀) of the four decapeptides and their acetylated derivatives as afunction of nominal charge at pH ˜7. The free peptides, with charges of+8 and +7, are the most potent and demonstrate very similar potencies.Acetylated Pep-4, with a charge of +5, tends to be only slightly lesspotent than the unmodified peptides. The potency of acetylated Pep-1,with a charge of +3, is ˜5% of the free peptide, which has a charge of+7. While the potencies of peptides with a charge of +4 (namely,acetylated Pep-2 and Pep-3) are much lower than their unmodifiedcounterparts, the degree to which their potency is diminished appears tobe peptide dependent.

As expected, antimicrobial potency diminishes as peptide charge isdecreased. Going from a formal charge of +8 to +5 resulted in arelatively small decrease in potency (EC₅₀ 1.2→4.9 μg/ml). Largerdecreases in potency can be observed for peptides with nominal chargesof less than +5, with the peptide with the least positive charge(acetylated Pep-1 with a nominal charge of +3) demonstrating an EC₅₀ of˜39 μg/ml, approximately a sixteen fold decrease in potency relative tofree Pep-1 with a nominal charge of +7. Acetylated Pep-2 and Pep-3 bothhad a nominal charge of +4, but they tend to demonstrate very differentantimicrobial potencies, with a nearly 10-fold difference in their EC₅₀values (8.1 and −70 μg/ml respectively).

The dramatic difference in the antimicrobial potencies demonstrated byacetylated Pep-2 and Pep-3 is interesting. These acetylated peptidesachieve their nominal +4 charge by different means. In acetylated Pep-2,Lys4 may be replaced with an Arg residue, which can result in thepeptide having one less acetylation site. Such replacement helpspreserve the positive charge at this position in the acetylated peptide.

In contrast, acetylated Pep-3 generally retains all of the availableacetylation sites (primary amino groups) that are present in Pep-1. But,the C-terminal carboxyl group may be been replaced with a C-terminalamide. This function effectively eliminates the only group present inthe peptide with a negative charge at pH ˜7.5. The fact that thesepeptides display such different antimicrobial potencies suggests thatfeatures other than nominal net charge play a significant role in theirantimicrobial effectiveness, at least in peptides with intermediatecharges.

While their acetylated counterparts display dramatically differentantimicrobial potencies, free Pep-3 and Pep-2 demonstrate nearlyidentical antimicrobial potencies, despite the fact that Pep-3 has anominal charge that is +1 greater than Pep-2 (+8 and +7 respectively).Such potency characteristic suggests that derivatives/variants of Pep-1with intermediate charges tend to be more sensitive to mechanisticperturbation. The behavior of the free and acetylated peptides mayprovide insights into the antimicrobial mechanism employed by thesepeptides. The increased potency of acetylated Pep-2 relative toacetylated Pep-3 could reflect how differences in the distribution andnumber of charged groups between the two peptides impact theantimicrobial mechanism.

Acetylated Pep-2 generally contains five arginine residues. Each maycontribute a positively-charged side chain, as well as anegatively-charged C-terminal carboxylic acid group. While acetylatedPep-3 may contain less arginine residues, it has a neutral C-terminalcarboxamide in place of the carboxylic acid group present in Pep-2.Furthermore, it has been recently reported that substituting arginineresidues for lysine residues in human alpha-defensin-1 (HNP-1) resultedin a significant increase in antimicrobial potency. It should be notedthat this effect was not observed when similar substitutions were madein the sequence of hBD-1. According to the current literature, thepotency difference observed for HNP-1 may be attributable in part to thefact that the guanidino group of arginine residues may interact withnegatively charged and polar groups to a greater extent than can theprimary amino group of the lysine side chain. Such interaction mayimpact how the peptide and the bacterial membrane interact with eachother, and the overall antimicrobial effectiveness of the peptide.

The free decapeptides and their acetylated derivatives may be incubatedwith horse erythrocytes to evaluate their hemolytic activity, which isnot an uncommon occurrence for antimicrobial peptides. The full-lengthhBD-3 and disulfide isoforms of the defensin have been reported todemonstrate significant hemolytic activity at elevated peptideconcentrations. Additionally, other short peptides have been reported todemonstrate hemolytic activity.

A wider range of peptide concentrations was used in these assays, withconditions expanded to include peptide concentrations of up to ˜1 mg/ml,in these assays, the free and acetylated peptides demonstrated nosignificant hemolytic activity at the concentrations used in evaluatingantimicrobial activity (˜0.1-˜100 μg/ml). Results of these assays appearin FIG. 21. Specifically, hemolytic activity of (A) Pep-1, Pep-2, Pep-3,and Pep-4 and (B) acetylated Pep-1, Pep-2, Pep-3, and Pep-4 is shown.Absorbance at 540 nm was used to monitor the release of hemoglobin byhorse erythrocytes that have been incubated with varied concentrationsof free peptide or acetylated peptide.

Free Pep-1, Pep-2, Pep-3, and Pep-4 showed slight hemolytic activity(<˜2%) at a concentration of ˜1 mg/ml, and their acetylated counterpartsshowed no significant propensity to lyse erythrocytes even at this highconcentration. These results suggest that the free and acetylatedpeptides attack bacterial cells, such as E. coli, at significantly lowerconcentrations than is required for them to demonstrate any effectagainst erythrocytes.

E. CONCLUSION

The performance of the free and acetylated peptides described heresuggests that the relationship between their antimicrobial propertiesand peptide charge is more complex than merely being a function of netcharge. This discovery is most evident in the performance of acetylatedderivatives of Pep-2 and Pep-3. Both have nominal net charges of +4, butthey also demonstrate very different potencies. Whether the disparity inantimicrobial potencies displayed by these acetylated peptides is theresult of differences in charge distribution in the peptides or theArg/Lys substitution in Pep-2 is not clear. While it has been reportedthat hBD-3 disrupts membranes, the same may not be true for Pep-1 andthe variants described herein. The lack of structure and short sizesuggest that their antimicrobial mechanism differs from that employed byfull-length hBD-3. While these decapeptides do not readily fit into anyof the commonly described structural classes, their sequences doresemble those of peptides associated with membrane translocation.Therefore, it is possible that these peptides may derive part of theirantimicrobial potency by targeting internal systems. Meanwhile, itshould be noted that it has been suggested that some CAMPs may alsotarget external (non-membrane) and intracellular systems, which maycontribute to their microbicidal activity. Furthermore, it has beenreported that buforin II, a 21-residue CAMP, kills E. coli withoutlysing the bacterial membrane. Moreover, the peptide penetrated thebacterial membrane and that it bound both RNA and DNA in gel-retardationexperiments.

The foregoing descriptions of the embodiments of the present inventionhave been presented for purposes of illustration and description. Theyare not intended to be exhaustive or be limiting to the precise formsdisclosed, and obviously many modifications and variations are possiblein fight of the above teaching. The illustrated embodiments were chosenand described in order to best explain the principles of the presentinvention and its practical application to thereby enable others skilledin the art to best utilize it in various embodiments and with variousmodifications as are suited to the particular use contemplated withoutdeparting from the spirit and scope of the present invention. In fact,after reading the above description, it will be apparent to one skilledin the relevant art(s) how to implement the present invention inalternative embodiments. Thus, the present invention should not belimited by any of the above described example embodiments. For example,the present invention may be practiced over other animals (such astreatment of domestic animals in veterinary clinics).

In addition, it should be understood that any figures, graphs, tables,examples, etc., which highlight the functionality and advantages of thepresent invention, are presented for example purposes only. Thearchitecture of the disclosed is sufficiently flexible and configurable,such that it may be utilized in ways other than that shown. For example,the steps listed in any flowchart may be reordered or only optionallyused in some embodiments.

Further, the purpose of the Abstract is to enable the U.S. Patent andTrademark Office and the public generally, and especially thescientists, engineers and practitioners in the art who are not familiarwith patent or legal terms or phraseology, to determine quickly from acursory inspection the nature and essence of the present invention ofthe application. The Abstract is not intended to be limiting as to thescope of the present invention in any way.

Furthermore, it is the applicants' intent that only claims that includethe express language “means for” or “step for” be interpreted under 35U.S.C. §112, paragraph 6. Claims that do not expressly include thephrase “means for” or “step for” are not to be interpreted under 35U.S.C. §112, paragraph 6.

A portion of the present invention of this patent document containsmaterial which is subject to copyright protection. The copyright ownerhas no objection to the facsimile reproduction by anyone of the patentdocument or the patent invention, as it appears in the Patent andTrademark Office patent file or records, but otherwise reserves allcopyright rights whatsoever.

What is claimed is:
 1. A cationic antimicrobial peptide (CAMP)comprising at least one CAMP conjugated to an antimicrobial agent,wherein the CAMP: a. comprises a 10 to 14 amino acid sequence based on ahuman beta-defensin sequence; b. is connected to the antimicrobial agentdirectly or through a linker segment, the antimicrobial agent beingconnected to the CAMP or the linker segment through a stable orcleavable bond; and c. carries and facilitates the delivery of theconjugated antimicrobial agent to a microbe.
 2. The CAMP conjugate ofclaim 1, wherein the CAMP is based on the amino acid sequence of theC-terminal region of a human beta-defensin.
 3. The CAMP conjugate ofclaim 2, wherein the CAMP is based on the amino acid sequence of theC-terminal region of human beta-defensin-1, human beta-defensin-2, humanbeta-defensin-3, or human beta-defensin-4.
 4. The CAMP conjugate ofclaim 1, wherein the CAMP comprises an amide group located on theC-terminus.
 5. The CAMP conjugate of claim 1, wherein the linker segmentconnects the antimicrobial agent to the CAMP through acylation of theamino group of the N-terminus of the CAMP.
 6. The CAMP conjugate ofclaim 1, wherein the antimicrobial agent is levofloxacin,chloramphenicol, or a diazeniumdiolate.
 7. The CAMP conjugate of claim1, wherein the linker connects the antimicrobial agent to the CAMP viaan amide bond between a carboxyl group of the linker and a side chain ofa lysine residue of the CAMP.
 8. The CAMP conjugate of claim 1, whereinthe antimicrobial agent or the linker is connected to the CAMP via anamide bond formed with a primary amino group of at least one of theN-terminus of the CAMP and a lysine side chain of the CAMP.
 9. The CAMPconjugate of claim 1, wherein the CAMP carriers and facilitates thedelivery of more than one of the conjugated antimicrobial agent to themicrobe.
 10. A cationic antimicrobial peptide (CAMP) conjugatecomprising a CAMP conjugated to an antimicrobial agent, wherein theCAMP: a. comprises the amino acid sequence RGRKSSRRKK (SEQ ID NO:2); b.is connected to the antimicrobial agent directly or through a linkersegment, the antimicrobial agent being connected to the CAMP or thelinker segment through a stable or cleavable bond; and c. carries andfacilitates the delivery of the conjugated antimicrobial agent to amicrobe.
 11. The CAMP conjugate of claim 10, wherein the CAMP comprisesan amide group located on the C-terminus.
 12. The CAMP conjugate ofclaim 10, wherein the linker segment connects the antimicrobial agent tothe CAMP through acylation of the amino group of the N-terminus of theCAMP.
 13. The CAMP conjugate of claim 1, wherein the antimicrobial agentis levofloxacin, chloramphenicol, or a diazeniumdiolate.
 14. The CAMPconjugate of claim 1, wherein the linker connects the antimicrobialagent to the CAMP via an amide bond between a carboxyl group of thelinker and a side chain of a lysine residue of the CAMP.
 15. The CAMPconjugate of claim 1, wherein the antimicrobial agent or the linker isattached to the CAMP via an amide bond formed with a primary amino groupof at least one of the N-terminus of the CAMP and a lysine side chain ofthe CAMP.
 16. The CAMP conjugate of claim 1, wherein the CAMP carriersand facilitates the delivery of more than one of the conjugatedantimicrobial agent to the microbe.
 17. A method of producing a cationicantimicrobial peptide (CAMP) conjugate comprising: a. identifying asuitable carrier CAMP; b. identifying a suitable antimicrobial agent;and c. creating a conjugate by conjugating the CAMP of step a with theantimicrobial agent of step b, wherein the CAMP: i. comprises a 10 to 14amino acid sequence based on a human beta-defensin sequence; ii. isconnected to the antimicrobial agent directly or through a linkersegment, the antimicrobial agent being connected to the CAMP or thelinker segment through a stable or cleavable bond; and iii. carries andfacilitates the delivery of the conjugated antimicrobial agent to amicrobe.
 18. A method of producing a cationic antimicrobial peptide(CAMP) conjugate comprising: a. identifying a suitable carrier CAMPcomprising the amino acid sequence RGRKSSRRKK (SEQ ID NO:2); b.identifying a suitable antimicrobial agent; and c. creating a conjugateby conjugating the CAMP of step a with the antimicrobial agent of stepb, wherein the CAMP: i. comprises the amino acid sequence RGRKSSRRKK(SEQ ID NO:2); ii. is connected to the antimicrobial agent directly orthrough a linker segment, the antimicrobial agent being connected to theCAMP or the linker segment through a stable or cleavable bond; and iii.carries and facilitates the delivery of the conjugated antimicrobialagent to a microbe.